Nurses' Experiences of Using Coercion in Forensic and Non-Forensic Settings: A Constant Comparative Analysis.

Area of Science:

• Psychiatric Nursing
• Mental Health Care
• Forensic Psychiatry

Background:

• Coercive measures (seclusion, restraints, involuntary care) are increasingly used in psychiatric and forensic settings.
• These measures negatively impact individuals with mental illness and nursing staff.

Purpose of the Study:

• To compare nurses' perspectives on coercive measures in forensic versus general psychiatric care.
• To explore the ethical challenges and influencing factors in applying coercion.

Main Methods:

• Qualitative methodology using grounded theory.
• Constant comparative method for data analysis.
• Individual interviews with 18 nurses (9 from general psychiatry, 9 from forensic psychiatry).

Main Results:

• Identified four key categories: understanding coercion, justifications for its use, maintaining trust, and the influence of a control culture.
• Nurses in both settings encounter significant ethical dilemmas related to coercion.
• Factors like risk management and a paternalistic culture influence coercion's application.

Conclusions:

• Nurses in coercive psychiatric environments face ethical challenges, influenced by factors like risk management culture.
• Advocacy and empathetic care are crucial for preventing coercive measures.
• Highlights the duality of care and control in psychiatric nursing and the need for critical reflection.